SSM Health St. Clare Hospital - Baraboo
707 14Th St, Baraboo, WI · SSM Health · · NPI 1720472848
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Drain thyroid/tongue cyst CPT 60000 | not published | not published | $1,130.33 – $4,867.00 | 4 |
| Drain to peritoneal cavity CPT 49062 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $253.55 | $461.00 | $146.16 – $4,401.00 | 4 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $240.90 | $438.00 | $146.16 – $4,401.00 | 4 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $376.20 | $684.00 | $296.15 – $4,401.00 | 4 |
| Dressing change not for burn w/anes 15852 CPT 15852 | not published | not published | $538.41 – $4,401.00 | 4 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | not published | not published | $73.20 – $120.88 | 5 |
| Drill hole evac+/drg subdural hematoma 61108 CPT 61108 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | not published | not published | $4,867.00 – $4,867.00 | 1 |
| Driver pneumatic vad, rep HCPCS Q0480 | not published | not published | $83,176.32 – $110,901.76 | 2 |
| Drm agrft f/s/n/h/f/g/m ea CPT 15136 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Drm agrft t/a/l ea addl CPT 15131 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Drng appendix abscess open 44900 CPT 44900 | not published | not published | $4,867.00 – $4,867.00 | 1 |
| Drng hand tendon sheath 26020 CPT 26020 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Drng of eyelid abscess 67700 CPT 67700 | $740.30 | $1,346.00 | $231.23 – $4,401.00 | 4 |
| Drng of finger abscess comp 26011 CPT 26011 | not published | not published | $1,203.19 – $4,867.00 | 4 |
| Drng of hydrocele 55000 CPT 55000 | not published | not published | $515.87 – $4,401.00 | 4 |
| Drng of mouth lesion 40801 CPT 40801 | not published | not published | $392.90 – $4,401.00 | 4 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $2,358.24 – $6,687.00 | 4 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $871.75 – $4,867.00 | 4 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $2,415.31 – $6,687.00 | 4 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,676.40 | $3,048.00 | $1,203.19 – $4,867.00 | 4 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $7,789.00 – $11,044.00 | 2 |
| Drng peritoneal abscess open 49020 CPT 49020 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Drng salivary gland simple 42300 CPT 42300 | not published | not published | $1,130.33 – $4,867.00 | 4 |
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $392.90 – $4,401.00 | 4 |
| Dronabinol 2.5mg oral HCPCS Q0167 | not published | not published | $2.15 – $3.42 | 3 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | not published | not published | $10.19 – $12.43 | 2 |
| Drop lock knee HCPCS L2182 | not published | not published | $105.32 – $140.43 | 2 |
| Drop lock retainer each HCPCS L2785 | not published | not published | $27.32 – $36.42 | 2 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | not published | not published | $18.17 – $120.88 | 5 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | not published | not published | $17.41 – $120.88 | 5 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | not published | not published | $4.71 – $120.88 | 5 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | not published | not published | $72.20 – $120.88 | 5 |
| Drug admin & hemodynmic meas CPT 93463 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Drug assay caffeine CPT 80155 | $45.65 | $83.00 | $28.93 – $140.62 | 5 |
| Drug assay posaconazole CPT 80187 | $90.75 | $165.00 | $20.33 – $197.84 | 5 |
| Drug assay rufinamide CPT 80210 | $229.90 | $418.00 | $20.33 – $197.83 | 5 |
| Drug assay vedolizumab CPT 80280 | $312.95 | $569.00 | $28.93 – $281.47 | 5 |
| Drug assay voriconazole CPT 80285 | $90.75 | $165.00 | $20.33 – $197.84 | 5 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $13.98 – $136.00 | 5 |
| Drug of abuse screen urine CPT 80305 | not published | not published | $9.45 – $109.16 | 5 |
| Drug screening tapentadol CPT 80372 | $53.35 | $97.00 | $172.28 – $172.28 | 1 |
| Drug screen quant tiagabine CPT 80199 | $95.70 | $174.00 | $20.33 – $179.50 | 5 |
| Drug/substance nos 4-6 CPT 80376 | not published | not published | $172.28 – $172.28 | 1 |
| Drug test def 15-21 classes HCPCS G0482 | not published | not published | $149.06 – $1,211.52 | 5 |
| Drug test def 1-7 classes HCPCS G0480 | $34.38 | $62.50 | $85.82 – $583.32 | 5 |
| Drug test def 22+ classes HCPCS G0483 | not published | not published | $185.19 – $1,570.50 | 5 |
| Drug test def 8-14 classes HCPCS G0481 | not published | not published | $117.44 – $897.46 | 5 |
| Drug test def simple all cl HCPCS G0659 | not published | not published | $46.60 – $582.37 | 5 |
| Drug test prsmv instrmnt CPT 80306 | $78.65 | $143.00 | $12.86 – $145.58 | 5 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $286.55 | $521.00 | $46.60 – $582.37 | 5 |
| Drvvt confirm - quest CPT 85597 | $102.30 | $186.00 | $13.48 – $178.70 | 5 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $2,864.02 – $11,257.00 | 4 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | not published | not published | $1,422.56 – $6,687.00 | 4 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $296.15 – $4,401.00 | 4 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $296.15 – $4,401.00 | 4 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $538.41 – $4,401.00 | 4 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $538.41 – $4,401.00 | 4 |
| Dstry eye lesn,fdr vssl tech HCPCS G0186 | not published | not published | $400.67 – $2,628.00 | 3 |
| Ductogram sgl duct CPT 77053 | $453.75 | $825.00 | $173.82 – $434.44 | 3 |
| Duodenal exclusion CPT 48547 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Duodenal motility study CPT 91022 | not published | not published | $271.85 – $1,676.00 | 3 |
| Duplex scan bilateral study 93985 CPT 93985 | not published | not published | $173.82 – $231.76 | 2 |
| Duplex scan unilateral study 93986 CPT 93986 | not published | not published | $76.16 – $101.55 | 2 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $83.05 | $151.00 | $76.16 – $101.55 | 2 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | not published | not published | $157.30 – $209.73 | 2 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | not published | not published | $173.82 – $231.76 | 2 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | not published | not published | $65.96 – $161.98 | 5 |
| Dxa bone density axl vrt fx CPT 77085 | not published | not published | $76.16 – $438.29 | 3 |
| Dx aly aud oi snd prcsr 1st CPT 92622 | not published | not published | $93.74 – $124.98 | 2 |
| Dx bronchoscope/brush 31623 CPT 31623 | not published | not published | $1,296.65 – $4,867.00 | 4 |
| Dx bronchoscope/lavage 31624 CPT 31624 | not published | not published | $1,296.65 – $4,867.00 | 4 |
| Dx bronchoscope/wash 31622 CPT 31622 | not published | not published | $1,296.65 – $4,867.00 | 4 |
| Dx dark adaptation exam i&r CPT 92284 | not published | not published | $325.44 – $433.92 | 2 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $660.74 – $4,401.00 | 4 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $660.74 – $4,401.00 | 4 |
| Dx gastr intub w/asp spec CPT 43754 | not published | not published | $157.30 – $4,401.00 | 4 |
| Dx gastr intub w/asp specs CPT 43755 | not published | not published | $93.74 – $4,401.00 | 4 |
| Dx intraop epcar Ultrasound chd i&r CPT 76989 | not published | not published | $305.98 – $305.98 | 1 |
| Dx intraop epicar car Ultrasound chd CPT 76987 | not published | not published | $826.04 – $826.04 | 1 |
| Dx intraop thoracic aorta Ultrasound CPT 76984 | not published | not published | $265.21 – $265.21 | 1 |
| Dx laryngoscopy newborn CPT 31520 | not published | not published | $284.93 – $4,401.00 | 4 |
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $1,296.65 – $4,867.00 | 4 |
| Dx ntrop epcr Ultrasound chd img acq CPT 76988 | not published | not published | $523.20 – $523.20 | 1 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $182.01 – $4,401.00 | 4 |
| Dynamic surface emg CPT 96002 | not published | not published | $157.30 – $209.73 | 2 |
| Ear and throat examination CPT 92502 | not published | not published | $392.90 – $1,676.00 | 3 |
| Ear canal biopsy 69105 CPT 69105 | not published | not published | $1,130.33 – $4,867.00 | 4 |
| Ear cartilage graft CPT 21235 | not published | not published | $3,179.00 – $11,044.00 | 4 |
| Ear irrigation 69209 CPT 69209 | $173.80 | $316.00 | $42.98 – $4,401.00 | 4 |
| Ear protector evaluation CPT 92596 | not published | not published | $27.21 – $36.28 | 2 |
| Ecallantide injection HCPCS J1290 | not published | not published | $446.96 – $1,101.98 | 5 |
| Ecg 12 lead tracing only CPT 93005 | $188.10 | $342.00 | $42.98 – $57.30 | 2 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | not published | not published | $42.98 – $57.30 | 2 |
| Ecg < 30 days transmission & analysis CPT 93271 | $574.75 | $1,045.00 | $69.26 – $92.35 | 2 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.